Study sheds light on diabetes among Native Americans

When Kansas University journalism professor Teresa Trumbly Lamsam goes to her childhood home in Oklahoma, she takes sacks of groceries with her. She knows she won’t be able to buy the kind of healthy food she wants on the American Indian reservation where she is from.

Health experts say the lack of food stores on reservations is one factor contributing to the soaring Native American diabetes rate. But lack of food options on reservations is not something you’ll often read about, and that’s something Lamsam wants to change.

She and her research partner, Haskell Indian Nations journalism instructor Rhonda LeValdo-Gayton, are studying how the media portray diabetes among Native Americans. The hope is to shed light on the forces shaping the conversation on Native American diabetes and offer guidance for journalists on how to cover the issue to promote better health.

The work is personal for both women. Lamsam is disturbed by research indicating that if nothing changes, diabetes could help wipe out Native Americans in 100 years. LeValdo-Gayton has lost several family members to the disease and has two young children. She is determined to make sure the damaging cycle of diabetes does not touch them.

“I feel like we just really got to step this up,” LeValdo-Gayton said. “I feel like we’re going to lose people that we don’t want to lose.”

Irreplaceable knowledge

Nationally, about 16 percent of Native Americans have diabetes, more than double the rate found in Caucasians. Native Americans are three times more likely to die from diabetes than the general population, according to the U.S. Department of Health and Human Services. The disease is also striking more young people. The number of Native Americans ages 15 to 19 with diabetes increased by 68 percent from 1994 to 2004.

“If that doesn’t scare you, I don’t know what will,” Lamsam said. “What does that do to the lifespan of the population?”

Locally, there are at least three people under 40 on dialysis for diabetes, according to Dr. Dee Ann A. Deroin, a family physician in Lawrence.

“It stems from our change in lifestyle, the unavailability in healthy food and the decrease in healthy activity,” Deroin said.

For those with diabetes, the disease can mean blindness, amputated limbs, heart disease and kidney failure.

In Native American communities, diabetes is taking elders far too young, forcing adults in their 20s and 30s to become the keepers of the culture.

“We shouldn’t be at this point. We should be having them around us a lot longer to teach that next generation,” LeValdo-Gayton said.

She has lost three uncles and worries about what their absence means for her children’s cultural education.

“I am just floored by everything I still have to learn, and I have to seek it from somebody else now,” LeValdo-Gayton said. “I don’t want to see our next generation of people having to deal with death like this.”

Who you blame matters

Studies have shown the federal government is more likely to invest in fighting a disease if the public views the victims of the disease not at fault for contracting it.

Sixty years ago, smoking was seen as an individual’s choice. If you smoked, that was your business, and if smoking destroyed your body, that was your business, too.

But the conversation about smoking changed in the 1960s, when public health officials and the media began to emphasize nicotine’s powers to addict and smoking’s power to destroy. All of the sudden, perhaps smokers weren’t completely to blame. Major public policy changes followed, from surgeon general’s warnings to lawsuits draining hundreds of millions of dollars from the tobacco industry.

That model of framing a health issue — everything from HIV to obesity — as not just being the responsibility of the individual has been pushed by public health officials. It could be a way to combat diabetes.

“Mainstream news does influence public opinion and public policy in this country,” Lamsam said. “How they’re telling the story of diabetes makes a difference to what happens in D.C.”

In their pilot study completed this summer, Lamsam and LeValdo-Gayton found that during the past 14 years, news articles have framed Native Americans as being responsible for contracting diabetes because of bad eating habits or sedentary lifestyles.

Most articles did not look at the larger issues that might contribute to diabetes.

“We find predominately that the media frame the story to place responsibility for having diabetes on the individual,” Lamsam said.

But there are no magic words to make a person live healthier or lose weight.

“Weight loss requires fairly intensive management. We think about it like managing other chronic diseases,” said Christie Befort, an associate professor of preventive medicine and public health at KU’s School of Medicine.

There is a lack of nutritious food available on many reservations. For example, the Standing Rock Reservation in North Dakota has just one grocery store for a population of 8,000 spread over 3,500 square miles.

“The grocery store is very far away,” LeValdo-Gayton said. “It’s OK, but if you look at the selection of vegetables or fruit, it’s very minimal.”

Ultimately, Lamsam would like to see more success stories in tribal newspapers. There have been healthy living programs on reservations, and coverage of those types of things could make a difference.

“We’re talking about a collective culture, not an individualistic culture,” Lamsam said. If people on a reservation see their friends and neighbors are living more healthy, it would probably make it easier for them to live healthy lives as well.

“You don’t have to do it all at once. Just change one bad habit, one at time,” LeValdo-Gayton said. “Then you slowly understand how it can affect you.”